Abstract
Fatal dog attacks are rare but devastating events with significant public health, forensic, and legal implications. Italy lacks a centralized registry for such incidents, limiting the ability to monitor trends and implement preventive strategies. This retrospective study analyzes all verified fatal dog attacks in Italy from 2009 to 2025. Data were collected from national and regional media, cross-verified, and organized into a comprehensive database. Descriptive statistics, chi-square tests, logistic and Poisson regressions, and interaction analyses were performed to identify patterns in victim demographics, breed involvement, ownership status, and environmental context. A total of 54 fatal attacks were recorded, with an increasing trend observed in the last five years. Elderly individuals (≥65) and preschool-aged children (≤4) were the most affected groups. Molosser and bull-type breeds were implicated in 69% of cases, and 92.6% of attacks involved owned dogs-more than half belonging to the victim. Private settings accounted for 66.7% of incidents. Comparative analysis with U.S. data revealed similar demographic and breed-related patterns, but also highlighted Italy's lack of a centralized behavioral risk registry. Fatal dog attacks in Italy follow recurring and preventable patterns. The absence of a national database severely limits surveillance and intervention. A centralized behavioral risk registry, modeled on international systems, should be established to support early detection, policy development, and multidisciplinary collaboration.